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Article: Evaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis
Title | Evaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis |
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Authors | |
Issue Date | 2013 |
Publisher | Springer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org |
Citation | Annals of Surgical Oncology, 2013, v. 20 n. 4, p. 1329-1335 How to Cite? |
Abstract | BACKGROUND: Because patients with differentiated thyroid carcinoma (DTC) presenting with distant metastasis (DM) have a particularly poor prognosis, examining the prognostic factors in this group is essential. We aimed to evaluate the prognostic factors affecting cancer-specific survival (CSS) in DTC patients presenting with DM. METHODS: Of the 1227 DTC patients, 51 (4.2 %) presented with DM at diagnosis. All patients underwent a total thyroidectomy, followed by radioiodine (RAI) ablation and postablation whole body scan (WBS). Patients were considered to have an osseous metastasis if one of the metastatic sites involved a bone, while RAI avidity was determined by any visual uptake in a known metastatic site on the first WBS. Factors predictive of CSS were determined by univariate and multivariate analyses by the Cox proportional hazard model. RESULTS: In univariate analysis, older age (relative risk [RR] 1.050, 95 % confidence interval [CI] 1.010-1.091, P = 0.014), DM discovered before WBS (RR 3.401, 95 % CI 1.127-10.309, P = 0.030), follicular thyroid carcinoma (RR 3.095, 95 % CI 1.168-8.205, P = 0.025), osseous metastasis (RR 4.695, 95 % CI 1.379-15.873, P = 0.013), non-RAI avidity (RR 3.355, 95 % CI 1.280-8.772, P = 0.014), and external beam radiotherapy to DM (RR 3.241, 95 % CI 1.093-9.614, P = 0.034) were significant poor prognostic factors for CSS. In the multivariate analysis, after adjusting for other factors, osseous metastasis (RR 6.849, 95 % CI 1.495-31.250, P = 0.013) and non-RAI avidity (RR 7.752, 95 % CI 2.198-27.027, P = 0.001) were the two independent poor prognostic factors for CSS. Older age almost reached statistically significance (RR 1.055, 95 % CI 0.996-1.117, P = 0.068). CONCLUSIONS: DTC patients presenting with DM accounted for 4.2 % of all patients. Because osseous metastasis and RAI avidity were independent prognostic factors, future therapy should be directed at improving the treatment efficacy of osseous and/or non-RAI-avid metastases. |
Persistent Identifier | http://hdl.handle.net/10722/174150 |
ISSN | 2023 Impact Factor: 3.4 2023 SCImago Journal Rankings: 1.037 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lang, BHH | en_US |
dc.contributor.author | Wong, KP | en_US |
dc.contributor.author | Cheung, CY | en_US |
dc.contributor.author | Wan, KY | en_US |
dc.contributor.author | Lo, CY | en_US |
dc.date.accessioned | 2012-11-16T03:37:04Z | - |
dc.date.available | 2012-11-16T03:37:04Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.citation | Annals of Surgical Oncology, 2013, v. 20 n. 4, p. 1329-1335 | en_US |
dc.identifier.issn | 1068-9265 | - |
dc.identifier.uri | http://hdl.handle.net/10722/174150 | - |
dc.description.abstract | BACKGROUND: Because patients with differentiated thyroid carcinoma (DTC) presenting with distant metastasis (DM) have a particularly poor prognosis, examining the prognostic factors in this group is essential. We aimed to evaluate the prognostic factors affecting cancer-specific survival (CSS) in DTC patients presenting with DM. METHODS: Of the 1227 DTC patients, 51 (4.2 %) presented with DM at diagnosis. All patients underwent a total thyroidectomy, followed by radioiodine (RAI) ablation and postablation whole body scan (WBS). Patients were considered to have an osseous metastasis if one of the metastatic sites involved a bone, while RAI avidity was determined by any visual uptake in a known metastatic site on the first WBS. Factors predictive of CSS were determined by univariate and multivariate analyses by the Cox proportional hazard model. RESULTS: In univariate analysis, older age (relative risk [RR] 1.050, 95 % confidence interval [CI] 1.010-1.091, P = 0.014), DM discovered before WBS (RR 3.401, 95 % CI 1.127-10.309, P = 0.030), follicular thyroid carcinoma (RR 3.095, 95 % CI 1.168-8.205, P = 0.025), osseous metastasis (RR 4.695, 95 % CI 1.379-15.873, P = 0.013), non-RAI avidity (RR 3.355, 95 % CI 1.280-8.772, P = 0.014), and external beam radiotherapy to DM (RR 3.241, 95 % CI 1.093-9.614, P = 0.034) were significant poor prognostic factors for CSS. In the multivariate analysis, after adjusting for other factors, osseous metastasis (RR 6.849, 95 % CI 1.495-31.250, P = 0.013) and non-RAI avidity (RR 7.752, 95 % CI 2.198-27.027, P = 0.001) were the two independent poor prognostic factors for CSS. Older age almost reached statistically significance (RR 1.055, 95 % CI 0.996-1.117, P = 0.068). CONCLUSIONS: DTC patients presenting with DM accounted for 4.2 % of all patients. Because osseous metastasis and RAI avidity were independent prognostic factors, future therapy should be directed at improving the treatment efficacy of osseous and/or non-RAI-avid metastases. | - |
dc.language | eng | en_US |
dc.publisher | Springer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org | - |
dc.relation.ispartof | Annals of Surgical Oncology | en_US |
dc.rights | The original publication is available at www.springerlink.com | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | Evaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis | en_US |
dc.type | Article | en_US |
dc.identifier.email | Lang, BHH: blang@hku.hk | en_US |
dc.identifier.email | Lo, CY: cylo@hkucc.hku.hk | en_US |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1245/s10434-012-2711-x | - |
dc.identifier.pmid | 23104708 | - |
dc.identifier.scopus | eid_2-s2.0-84875149129 | - |
dc.identifier.hkuros | 212309 | en_US |
dc.identifier.isi | WOS:000316392600040 | - |
dc.publisher.place | United States | - |
dc.identifier.citeulike | 11607991 | - |
dc.identifier.issnl | 1068-9265 | - |